Volume 49 Number 3

Updates on pathogenesis of Helicobacter pylori-Opisthorchis viverrini co-infections induced cholangiocarcinoma

Banchob Sripa^a,*,?, Raksawan Deenonpoe^b

 
ABSTRACT:     Opisthorchiasis, caused by the liver fluke Opisthorchis viverrini (OV) infection, is a major public health issue in the Lower Mekong Basin. Chronic OV infection is associated with several hepatobiliary pathology including advanced periductal fibrosis (APF) and cholangiocarcinoma (CCA), a fatal bile duct cancer. Recent evidence implicates Helicobacter pylori, especially cagA-positive strains, as significant contributors to APF and CCA in co-infected individuals. This review explores the multifaceted interactions between O. viverrini and H. pylori, emphasizing the role of the liver f luke as a reservoir and vector for H. pylori. Evidence reveals that H. pylori colonizes the gastrointestinal tract of O. viverrini via sugar moieties, such as L-fucose, of the receptors, enabling bacterial transmission to the human biliary tree. Once in thebile ducts, H. pylori adheres to cholangiocytes, triggering inflammation mediated by sialic acid-binding adhesins and the release of pro-inflammatory cytokines such as IL-6 and TNF-?. The bacterium?s ability to induce epithelial-to-mesenchymal transition (EMT) further enhances the invasive and malignant potential of biliary epithelial cells. This review highlights the emerging understanding of the synergistic pathogenesis of O. viverrini and H. pylori co-infections, providing insights into molecular mechanisms, host-pathogen interactions, and the inflammatory milieu that drive CCA development. These findings underscore the need for integrated therapeutic strategies targeting both pathogens to mitigate the burden of APF and CCA in endemic regions.

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* Corresponding author, E-mail: banchob@kku.ac.th

Received 16 Dec 2024, Accepted 31 Jan 2025